Innovative histological and histochemical characterization of tongue biopsies from patients with burning mouth syndrome.

OBJECTIVES: The present pilot study aims to perform an innovative histological and histochemical characterization of samples from patients with burning mouth syndrome (BMS) to correlate these findings with the clinical scenario. METHODS: To carry out this objective, the study samples were stained with the hematoxylin-eosin stain and later, an histochemical study was carried out to determine the composition of the extracellular matrix (ECM) using the stains of Alcian Blue, Picrosirius, Reticulin from Gomori and Verhoeff. RESULTS: The results of this study revealed histological patterns compatible with cellular hypertrophy in different layers of the epithelium as well as a greater keratinization in BMS cases. On the other hand, a lower amount of proteoglycans and a greater amount of collagen fibers were observed compared to the control. In addition, older patients had fewer reticular fibers and younger patients had fewer elastic fibers compared to the control. CONCLUSIONS: In conclusion, the present study shows the existence of a correlation between the histological patterns, age and symptoms of patients with BMS. Therefore, it is necessary to develop synergistic studies in order to assess and implement new classification systems that could improve the therapeutic approach of patients with BMS.

Osteocalcin in serum, saliva and gingival crevicular fluid: their relation with periodontal treatment outcome in postmenopausal women.

BACKGROUND: Osteocalcin levels have been postulated as a marker of inhibition of bone formation. The aim of the present study was to assess plasma, saliva and GCF levels of osteocalcin and correlate them with periodontal treatment outcome in postmenopausal women. METHODS: Thirty-nine postmenopausal women (57.8 -/+8.5 years old) were recruited for the study. Periodontal examination of all women was carried out and plaque, bleeding on probing, probing depth (PD), and clinical attachment level (CAL) were recorded. Serum, saliva and gingival crevicular fluid osteocalcin were measured. Then, periodontal treatment was carried out. Six months after the first appointment a second periodontal examination was carried out. RESULTS: Mean PD and mean CAL decreased significantly at second appointment in the group with serum osteocalcin concentration <10 ng/ml (15.8 -/+15.8% and 15.3 -/+ 21.2% respectively; p < 0.05). Mean PD decreased significantly at second appointment in the groups with saliva osteocalcin concentration < 3 ng/ml (17.1 -/+ 15.9%; p < 0.05) and 3-7 ng/ml (16.2 -/+18.1%; p < 0.05). CONCLUSIONS: Low serum osteocalcin concentration is associated to a significantly higher percentage of decrease in PD and CAL after periodontal treatment in postmenopausal women. Low saliva osteocalcin concentrations are significantly associated to a higher percentage of decrease in PD.

Serum, saliva, and gingival crevicular fluid osteocalcin: their relation to periodontal status and bone mineral density in postmenopausal women.

BACKGROUND: Periodontitis and osteoporosis are characterized by the loss of bone mass. Osteocalcin levels have been postulated as a marker of inhibition of bone formation. The aim of the present study was to assess plasma, saliva, and gingival crevicular fluid (GCF) levels of osteocalcin and correlate them with periodontitis and osteoporosis. METHODS: Seventy-three postmenopausal women, over 35 years old, were recruited for the study. Serum, saliva, and GCF osteocalcin were measured. Vertebral bone mineral density was measured by dual-energy x-ray absorptiometry. Differences between groups were assessed by analysis of variance (ANOVA), chi-square test, and non-parametric Kruskal-Wallis test. RESULTS: Thirty-four (46.6%) were classified in the normal healthy bone group, 11 women (15.1%) in the osteopenic group, and 28 women (38.4%) in the osteoporotic group. No statistically significant differences between these densitometric groups were observed in probing depth (P = 0.24); clinical attachment level (P = 0.11); or mean osteocalcin concentrations in serum, saliva, and GCF. Twenty-seven (37.0%) of the women were classified without periodontitis (NPG) and 63.0% (N = 46) with periodontal disease (PG). There were no statistical differences in serum and saliva osteocalcin concentrations between these two groups. GCF osteocalcin concentrations were significantly higher in the PG women than in the NPG group (P = 0.008). Mean probing depth correlated significantly with GCF osteocalcin concentrations (r = 0.35; P = 0.002). CONCLUSION: The results further support the concept that osteocalcin levels in GCF correlates with periodontal but not with osteoporosis status.

Correlation between infant birth weight and mother's periodontal status.

OBJECTIVES: Recent studies have suggested that periodontal disease is a risk factor for low birth weight (LBW) with other multiple factors. A cross-sectional study was undertaken to help further evaluate the proposed association between periodontal disease and infant birth weight. MATERIAL AND METHODS: Caucasian pregnant women (n=152), aged 14-39 years, were enrolled while receiving prenatal care. Dental plaque, probing depth, bleeding on probing and clinical attachment level were recorded and three groups were made: healthy group (HG) (n=38), gingivitis group (GG) (n=71) and periodontitis group (PG) (n=43). At delivery, birth weight was recorded. RESULTS: Infant mean weight at delivery was 3293.9+/-508.1 g. The total incidence of preterm birth and LBW infants was 5.3% and 4.6%, respectively. The incidence of LBW infants was 3.5% in term gestations and 25% in preterm gestations. Mothers height correlated with infant birth weight (p=0.03). Significant difference in birth weight existed between mothers with <1.55 m (3229.23+/-462.57) and those with > or =1.65 m (3475.55+/-505.07). In the group of women >25 years old infant mean weight in HG was 3588.33+/-531.83, being lower in GG (3466.75+/-334.45) and even lower (3092.60+/-592.94) in PG (p=0.0198). Bleeding on probing was significantly greater in women with <2500 g infants (40.2+/-21.8%) compared with 2500-3499 g (18.6+/-15.1%) and > or =3500 g (17.1+/-16.1%) (p=0.009). CONCLUSIONS: Periodontal disease in normal Caucasian pregnant women, older than 25 years, is statistically associated with a reduction in the infant birth weight. These data provide new evidence on the relationship between periodontal disease and birth weight.

Evaluation of medical risk in dental practice through using the EMRRH questionnaire.

OBJECT: Due to the fact that the population is getting older and to new medical and dental techniques, the number of medical complications during treatment is tending to increase. In order to avoid these complications a correct clinical history should be obtained of all these patients. The search for a suitable questionnaire which would be able to take into account all these factors is therefore necessary. MATERIAL AND METHOD: In this study we have used the questionnaire EMRRH which has been proposed by a group of European investigators, in order to study the prevalence of past medical problems in a population that attends a dental clinic for treatment. RESULTS: A total number of 716 patients were registered. Of these, 219 had a medical history that was of some interest to us. There were significant differences between the average age of the population with or without former medical problems (p<0.0005). Secondly, out of the 30.6% of the population with medical problems (N=219), we separated into groups those patients who would have a low, medium or high risk of complications when submitted to dental treatment. 17.31% of the patients were classified as risk ASA II; 9.49% as ASA III, and 2.51% as ASA IV. Among the diverse pathologies the highest percentage was hypertension (13.8%), followed by allergies to different drugs (8.37%), palpitations (7.82%), respiratory pathologies (5.16%) and diabetes (4.3%). CONCLUSION: We can see the obvious need for a detailed medical history to be taken because of the existing prevalence of these above pathologies taking into account that without one we could seriously harm the patient health with our dental treatment.

Oral manifestations caused by the linear IgA disease.

The Linear IgA deposit related disease or Linear IgA disease (LAD) is a chronic, uncommon and autoimmunological mucocutaneous disease, characterised by linear IgA deposits along the basement membrane zone. In mainly cases, moreover cutaneous lesions, there are oral mucosal and other mucosal lesions. There are also, some cases published of Linear IgA disease limited to oral mucosa. The known of this disease is important for the establishment of a correct differential diagnosis in cases of blistering mucocutaneous diseases. In this paper, we analyze the most important features of this disease, attending specially to the oral manifestations.